Mandibular Advancement Device in Cologne – Cost, Insurance & Procedure for Snoring and Sleep Apnea

You can get a custom-made mandibular advancement device (an appliance that holds the lower jaw forward) at JUST KFO – Dr. Steinmaier & Kollegen in Köln (Hauptstraße 50). The appliance is custom-made in our in-house master dental laboratory after a digital 3D scan and is used in coordination with sleep physicians and ENT doctors – effective against snoring and mild to moderate obstructive sleep apnea. Unlike standard appliances from the drugstore, the custom-made device fits precisely and is fine-tuned to your individual degree of advancement. You can book a consultation appointment online.

Costs depend on type, material, and manufacturer. An individually fitted mandibular advancement device usually costs between 1,000 and 2,200 euros in Germany. In cases of medically confirmed obstructive sleep apnea, statutory health insurance covers the device if continuous positive airway pressure therapy (CPAP) cannot be used successfully — details in the section Costs and Insurance.

Mandibular advancement devices are an established option for snoring and for mild to moderate obstructive sleep apnea. A custom-fitted device moves the lower jaw slightly forward and thereby helps keep the airway open – the soft palate and tongue are less likely to fall back. This reduces snoring and pauses in breathing. Compared with CPAPtherapy or surgery, it is less invasive and easier to use. When it fits well, it can noticeably improve sleep quality. In a randomized study using custom-made devices, 84 percent of bed partners reported quieter snoring and 76 percent reported snoring on fewer nights per week.

A mandibular advancement device can be prescribed by a dentist, an orthodontist or a sleep physician. Orthodontists have particular experience in making and fitting these devices, since snoring is often related to jaw or tooth misalignment. Before a device is fitted, the underlying causes should be carefully investigated. Since 2021 the following applies in Germany: if a physician has diagnosed obstructive sleep apnea, statutory health insurance may cover a mandibular advancement device under certain conditions.

A few measures can reduce snoring quickly:

• Sleeping position: sleeping on your side or with your head slightly raised improves airflow.
• Relaxing the jaw muscles: targeted exercises can help.
• Nasal strips or nasal dilators: these improve breathing through the nose.
• Avoiding alcohol and sedatives: they relax the muscles of the throat and make snoring worse.
• Mandibular advancement device: a custom-fitted device often reduces snoring considerably.

Which option suits you best is something we clarify after a diagnosis. Avoid alcohol in the evening – in an analysis of 13 sleep laboratory studies, there were on average around four more pauses in breathing per hour with alcohol than without.

Yes – a dentist can improve your oral health and fit a mandibular advancement device. An orthodontist additionally brings experience with jaw misalignment and airway problems, which are often behind snoring. The orthodontist investigates the cause and offers a suitable therapy – for example a mandibular advancement device, jaw correction or exercises for the jaw muscles. Around 95 percent of people with obstructive sleep apnea snore – which is why, before any device is fitted, we work together with a physician qualified in sleep medicine to find out what lies behind your snoring.

Yes – an ENT doctor examines the airways and may recommend, for example, nasal surgery or CPAP therapy. If the snoring is related to the jaw or the teeth, the orthodontist adds a mandibular advancement device or jaw correction. The two often work together in order to cover both cause and treatment comprehensively. In a randomized study, the number of nighttime breathing pauses after palate-and-throat surgery fell below 20 per hour in 59 percent of those who had the operation, compared with 6 percent in the untreated control group – whether such a procedure is an option is decided by the ENT doctor.

They are effective for snoring and mild to moderate sleep apnea.1 The device advances the lower jaw slightly forward and keeps the airway open, reducing snoring and breathing interruptions. For most patients, snoring can be successfully reduced or eliminated this way. It is less invasive than CPAP or surgery; what matters are precise, individual fitting and correct positioning.

For mild to moderate obstructive sleep apnea, mandibular advancement devices are a guideline-supported alternative to CPAP therapy.1

The best appliance depends on your individual needs—in most cases, a custom-made device from an orthodontist is the right choice. It should fit comfortably, not disturb your sleep, and be made of high-quality, hygienic material. Because it is tailored to your anatomy, it usually fits more comfortably than a prefabricated appliance. In a randomized comparison study, a custom-made appliance fabricated in the laboratory was successful in 60 percent of participants, while a prefabricated appliance from a boil-and-bite kit was successful in only 31 percent.

How long a device lasts depends on the material, how it is used and how it is cared for. A high-quality, custom-fitted device normally lasts a long time. Over time, however, it can wear down – have it checked regularly and readjusted if needed so that it remains effective. We will also give you tips on caring for it. In one observational study, the average time a device was worn before being replaced was just under three years; independently of this, the condition of the device should be checked every six to twelve months, depending on your individual risk profile.

Snoring is best stopped by addressing its cause. To do this, the orthodontist determines what lies behind it – for example a narrowed airway or a jaw or tooth misalignment – and recommends a suitable treatment: a mandibular advancement device (it moves the lower jaw forward and helps keep the airway open), a jaw correction, or specific exercises for the jaw muscles. In most people, snoring can be reduced or eliminated this way. In around 62 percent of those affected, the nighttime pauses in breathing occur mainly when lying on the back, and aids that prevent sleeping on the back reduced their number in studies by an average of about 43 percent.

Partly – certain exercises can strengthen or relax the jaw and throat muscles and reduce snoring; however, they have to be done in a targeted way and regularly. Often a treatment tailored to the cause is more effective: after a diagnosis, options include a mandibular advancement device, a jaw correction or additional exercises. This combination usually gives more lasting results. In a review of nine studies, targeted exercises for the tongue, palate and throat reduced the proportion of sleep time spent snoring from around 14 to about 4 percent on average – but only with regular practice over several months.

Many notice improvement within the first few nights. It may take several weeks for the lower jaw to adjust to the advanced position and for the optimal setting to be found; readjustment is normal.

Clean daily with lukewarm water and a soft toothbrush. Hot water will warp the material. During follow-up appointments, we check fit and condition.

If you experience breathing interruptions, severe daytime fatigue, or morning headaches, the first step is a sleep medicine evaluation. Only after a confirmed diagnosis can it be determined whether a mandibular advancement device is the appropriate therapy.